Abstract：
Measure effectiveness of a non-pharmacological approach to manage postoperative nausea (PON) by applying an ice pack to the posterior upper neck.
This was an observational quality improvement project. The sample included adults 18 years old and older who received general anesthesia (inhalation and/or intravenous), recovering in Phase I or Phase II postoperative care unit (PACU) experiencing very mild to moderate nausea. Exclusion criteria were patients who experienced severe nausea or were actively vomiting; were admitted for head or neck plastic surgery; were hypothermic (< 36.0°C); patients who refused the ice pack, or the provider stated that placing an ice pack to the patient\'s posterior upper neck was contraindicated.
Patients who experienced mild to moderate PON had an ice pack applied to the posterior upper neck as first line management. If the patient\'s nausea continued to progress or did not improve within five minutes of ice pack application the patient was offered a different non-pharmacological approach or pharmacological approach to prevent vomiting as per standards of care. Demographics were collected and patient\'s level of nausea was documented at the time of ice pack application and after five minutes.
Of the 70 patients included in this study, 61% reported ice pack application as effective in mitigating their nausea, 14% were unsure, and 24% reported not effective. There was a significant decrease in nausea between baseline (2.3 ± 0.6; range 1-3) and five minutes post application (1.5 ± 1.1; range 0-4). The within subject baseline-post change (↓0.9 ± 1.1; P < .001) reflected a decrease in nausea.
Application of an ice pack to the posterior upper neck, may effectively decrease very mild to moderate PON.
This was an observational quality improvement project. The sample included adults 18 years old and older who received general anesthesia (inhalation and/or intravenous), recovering in Phase I or Phase II postoperative care unit (PACU) experiencing very mild to moderate nausea. Exclusion criteria were patients who experienced severe nausea or were actively vomiting; were admitted for head or neck plastic surgery; were hypothermic (< 36.0°C); patients who refused the ice pack, or the provider stated that placing an ice pack to the patient\'s posterior upper neck was contraindicated.
Patients who experienced mild to moderate PON had an ice pack applied to the posterior upper neck as first line management. If the patient\'s nausea continued to progress or did not improve within five minutes of ice pack application the patient was offered a different non-pharmacological approach or pharmacological approach to prevent vomiting as per standards of care. Demographics were collected and patient\'s level of nausea was documented at the time of ice pack application and after five minutes.
Of the 70 patients included in this study, 61% reported ice pack application as effective in mitigating their nausea, 14% were unsure, and 24% reported not effective. There was a significant decrease in nausea between baseline (2.3 ± 0.6; range 1-3) and five minutes post application (1.5 ± 1.1; range 0-4). The within subject baseline-post change (↓0.9 ± 1.1; P < .001) reflected a decrease in nausea.
Application of an ice pack to the posterior upper neck, may effectively decrease very mild to moderate PON.
摘要：
通过在后上颈部施加冰袋来测量非药物方法管理术后恶心（PON）的有效性。
这是一个观察性的质量改进项目。样本包括18岁及以上接受全身麻醉（吸入和/或静脉注射）的成年人，在I期或II期术后监护病房（PACU）恢复，经历轻度至中度恶心。排除标准为经历严重恶心或主动呕吐的患者；接受头颈部整形手术；体温过低（<36.0°C）；拒绝冰袋的患者，或医疗服务提供者指出，在患者的后上颈部放置冰袋是禁忌的。
经历轻度至中度PON的患者将冰袋应用于后上颈部作为一线管理。如果患者的恶心持续进展或在使用冰袋后5分钟内没有改善，则根据护理标准，向患者提供不同的非药物方法或药物方法以防止呕吐。收集人口统计数据，记录患者在使用冰袋时和五分钟后的恶心水平。
在这项研究中纳入的70名患者中，61%的人报告说使用冰袋可以有效缓解他们的恶心，14%的人不确定。24%报告无效。在基线(2.3±0.6;范围1-3)和施用后5分钟(1.5±1.1;范围0-4)之间恶心显著降低。受试者基线-术后变化范围内的差异（7.9±1.1；P<.001）反映了恶心的减少。
将冰袋应用于后上颈部，可有效降低非常轻度至中度PON。
这是一个观察性的质量改进项目。样本包括18岁及以上接受全身麻醉（吸入和/或静脉注射）的成年人，在I期或II期术后监护病房（PACU）恢复，经历轻度至中度恶心。排除标准为经历严重恶心或主动呕吐的患者；接受头颈部整形手术；体温过低（<36.0°C）；拒绝冰袋的患者，或医疗服务提供者指出，在患者的后上颈部放置冰袋是禁忌的。
经历轻度至中度PON的患者将冰袋应用于后上颈部作为一线管理。如果患者的恶心持续进展或在使用冰袋后5分钟内没有改善，则根据护理标准，向患者提供不同的非药物方法或药物方法以防止呕吐。收集人口统计数据，记录患者在使用冰袋时和五分钟后的恶心水平。
在这项研究中纳入的70名患者中，61%的人报告说使用冰袋可以有效缓解他们的恶心，14%的人不确定。24%报告无效。在基线(2.3±0.6;范围1-3)和施用后5分钟(1.5±1.1;范围0-4)之间恶心显著降低。受试者基线-术后变化范围内的差异（7.9±1.1；P<.001）反映了恶心的减少。
将冰袋应用于后上颈部，可有效降低非常轻度至中度PON。
